Dr. Jon Hallberg: Taking care of ballplayers in spring training

The Minnesota Twins are in the final week of spring training. Players who make the team will return to a league that has introduced helmets to better protect them from concussions and stepped-up tests for steroids.

MPR's medical analyst Dr. Jon Hallberg serves as a physician for the Minnesota Twins. He discussed new medical developments this baseball season with Tom Crann of All Things Considered. Hallberg is a physician in family medicine at the University of Minnesota and medical director of the Mill City Clinic.

An edited transcript of that discussion is below.

Tom Crann: Drug testing is always a big issue every year, but what's new or what has changed this year?

Hallberg: There are two things that are happening. For the first time, the players are being tested for Human Growth Hormone... That's a blood test and that took a lot of doing to make that happen. That's one thing on the performance enhancing side of things.

On the other side, on the drug abuse side of the equation, there's always concern about marijuana use. That's the most common drug of abuse. We're dealing with young men who are all of college age.

The big thing this year is the use of synthetic marijuana, and this has been controversial back in Minnesota... This particular kind of synthetic drug has had some horrible consequences in young men. We're really getting out there and trying to encourage our guys not to even think about trying this stuff.

Crann: What is the tricky part about supplements?

Hallberg: There's something called NSF [International], which is sort of a consumer safety group that makes sure that things are what they say they are.

The trouble with supplements though, because of the broadly unregulated industry, is that it seems now that some companies are putting that label on their product if it was approved at one point, but not batch-by-batch or lot-by-lot. Sadly, sometimes the lots get contaminated or intentionally contaminated with substances that are not on the label that could give a player a positive drug test.

Major League Baseball and other organizations are starting to think that perhaps the majority of the positive drug tests for performance-enhancing substances are coming from the use of supplements. This is really frustrating because players are buying it at places like Vitamin Shoppe and GNC, and yet they're getting dinged.

If they get caught with a performance-enhancing substance in their urine, it's an instant 50-game suspension without pay. That's not days, that's games. That's a significant setback for them.

Crann: The advice there is just don't take them?

Hallberg: It is, and they sure don't want to hear that because these guys are trying so hard to make the team. In some cases, these guys are coming from Venezuela, the Dominican Republic, [living in] almost abject poverty. This is a huge dream and a goal. Everybody wants to try something that will give them an edge, and they want to at least try some supplements. And to be told, 'Guys, the only thing you should be doing is eating food and maybe taking a simple multivitamin if you want.' They just don't want to hear that.

Crann: There is continued concern over the long-term effects of concussions, especially with Justin Morneau. How are they addressing that this year?

Hallberg: One of the things they're doing is they have designed a new helmet. Justin is wearing it, as are a few of the other Twins players. This year it's optional, next year it won't be optional. There's going to be a new helmet that has some titanium in it. It looks a little more like the minor league helmets, which are a little bigger. Guys don't like them as much, but it's designed to hopefully help protect their heads better and decrease the rate of concussions.

Crann: It is the time of spring training when a lot of players get cut and others are dealing with health issues. We have this romantic idea of spring training, but it really is a time of tension and stress for players too. Do you deal with that as well?

Hallberg: That's a big part of my job. I work in the employee assistance program. I am dealing with the mental health side of things, along with another colleague that's working with the team. Initially, when spring training starts, it's very lighthearted, guys are kind of checking in.

[On] the last week of spring training, every single day, and even more than one time a day, guys are being cut, sent down. Or they're being cut altogether, being released in the hopes that they can catch on with another team.

Here we are in this beautiful state with this gentle breeze and blue skies and palm trees swaying, so from a fan perspective, it doesn't get much better than this. But from a player perspective, this is a really stressful time.